Saturday, December 18, 2010

The work*life product and other insights

We've been talking about work-life balance this week in the context of motherhood, but clearly this is a concern for anyone in medicine. Partly, I think this comes from the personalities that are generally attracted to/selected by the field, leaning towards the driven and perfectionistic (and at times, a-retentive), as well as the demands of caring for patients: hard to turn off, hand off, or leave at the door. For me, though, motherhood really made this concept all the more relevant, as suddenly the "Life" part of the equation got significantly more complex. Having to stay late at work takes on a whole new meaning when that means you might miss a meal or a bedtime of someone who is "your heart walking around outside of your body."

These past 5 1/2 years of motherhood and living work-life balance have given me some early insights:

Work-life balance is highly personal. Set your own standards.

We were on vacation over the summer at the beach for one week. During the week, I had a monthly work-related conference call for a national committee I serve on. I decided beforehand that I would see how the week was going (the call was near the end of our week away), and that I'd call in for it if I felt like it. Well, I felt like it. After spending 24/7, all-family, all-the-time, (including an 8-9 hour car ride involving listening to 2 hours+ of straight crying), I was ready for a brief break away, if only by phone. Yet, calling in and admitting that I was on family vacation at the beach and might not stay on for the whole call made me suddenly self-conscious, much like I feel self-conscious about sending colleagues manuscript drafts on Friday nights (I have). I wondered what they were thinking and whether my "balance" was questionable.

But, I have come I'm coming to accept the fact that I draw so much satisfaction, meaning, and identity from my work. I would be miserable not working at all and taking care of the kids full time. I would likely be miserable working only part time. Doing meaningful, satisfying work makes me happier when I am home, more patient, a better mother than I would be otherwise. And, I'm telling myself that it doesn't matter what others think, as long as I am happy with the way things are going, that my family is happy with the way things are going. Really, that's what matters, not someone else's standards. (And who cares what others think?)
There's no ideal "mix" or balance that fits everyone. Finding your own "groove," is key.

"Work-life balance" is a less helpful concept for me than "work-life product"

When I think about balance, I think about a see-saw, with work sitting on one side of the fulcrum and life on the other. That seems to denote that to be in balance means to have similar weighting to each side, in similar quantities. Yet, in real life, I feel that these weights are always in flux and being in a state of mental/emotional harmony depends on the work*life product to be under a certain threshold (much like the calcium-phos product). For instance, it would be okay if family needs became temporarily higher when work needs were low, or if a flurry of work demands occurred during times of quiet on the home front. But, when both of those demands become high for whatever reason, that's when things get untenable. Hopefully those times are only temporary, resulting in only a minor amount of pesky metastatic calcification (e.g. my nanny nightmare + temporary work insanity = sad me), but when they are sustained, then changes have to be made.

Your workplace "terroir" can greatly affect/encourage/stifle your sense of balance

In wine-making references, the term terroir refers to the sum effects of a local environment (the specific geography, climate, soil, farming techniques, etc) that results in the final product. At work, the organizational culture surrounding work-life issues-- managers, your boss, colleagues, inherent flexiblity of your job-- all contribute to your sense of balance. When I first started working at my job, I didn't feel it was very supportive to me as a new mother. When I announced my pregnancy, the first response was "how long will you be gone? 6 weeks?" (In my ideal world. it would have been, "Congratulations! *hug* How can I help you?") I was the only mother of my group and worked with many men who gave me a hard time for missing conferences due to pumping--I felt like a criminal trying to get out at a reasonable hour to see my child before her early bedtime. Yet, now, things have changed. Those men have left (hooray!), I've negotiated for more protected time (hooray!), and now, I have a supervisory role that allows me to create a environment that emphasizes the importance of work-life. Small gains like instituting policy and precedent for my section to take "in-lieu" days off for having to work a holiday hopefully will add up to an overall supportive culture. Finding a work environment that meshes with your own ideal of work-life balance can't be underestimated, and if not, work to change it if you can, either from within or finding a new job (like dr whoo courageously did).

Re-evaluate, re-evaluate, re-evaluate

As with any process, it helps to periodically re-evaluate to make sure things are going smoothly from everyone's perspectives. I remember one time when my husband mentioned (jokingly) something about how we both just tended to get absorbed in doing work side-by side on our laptops after the kids went to bed each night. It was totally true, and a reality check. It's so easy (for me) to get sucked into (bad) habits and not stop to reflect, or step away and see the big picture. I need to be reminded to take that time to re-evaluate and to check in with everyone.

Best of luck to all MiMs out there, finding your own work-life groove and defending it. And periodically checking in with all stakeholders (yourself, your partner, your children) to make sure nothing needs tweaking. And definitely keeping that work*life product to non-toxic levels.


  1. Thank you for your efforts in changing policy. It's important to communicate the challenges we facee and work towards making improvements for those who follow in our footsteps.

    I feel because we are skilled problem solvers we often solve our own individual problems without addressing the bigger issues that exist for all women. The first step, that we all can do, is to express the challenges that we encounter.

    The time has come to promote family-friendly work environments and I feel it is our responsibility as women and physicians to champion this for all.

  2. I see the term work*life, and I think "Interaction term!" I think I've been running my stats models for too long today.


  3. Ah, KC, send me a manuscript draft on a Friday night anytime and chances are I'll read it :-) Thanks for helping me understand your teroir and reflect upon mine. You have achieved a fabulous product.

  4. Agree on the need to find your own personal balance. When I was in early practice, working part-time, I was criticized equally for working too much and too little. Not sure how I managed to feel guilty about both at the same time, but I did. I now care much less about other people's opinions on what my work-life balance should look like.

  5. I think you are exactly right. As individuals we each have our own needs, as do our balance will never look quite the same for everyone. That is okay. As long as you're happy with the product, it doesn't matter if it is different than someone else's.

  6. Love the concept of the work*life product. And I want to echo the other posters on the kudos to you KC for getting into a position where you are influential in changing the work environment to be more understanding towards women/family life. I'm trying to do the same by becoming a chief resident in my program (I don't know if you remember my plea for help a few months ago regarding chief year, fellowship, or primary care... well I just found out I got the chief position! It was a good choice and it was helpful to have everyone's ideas at that time - so thanks again.) I too am trying to find some balance that works for our family, but in the inflexible world of residency, it's a fleeting calm between those rough call months.

  7. Congrats, Niquekee!

    KC - I love the work-life product concept as well. This is wonderfully well thought out! Thank you for sharing!

  8. k-kel: Amen. Totally agree. We need to start changing things.

    Old MD Girl: Well, it IS an interaction term...nothing wrong with a stats run. Have been doing my share lately too and have a new appreciation for what I used to have others do!

    T: Thank you for being ever supportive, even when you might not personally make the same choices...I really appreciate your perspective on things and the okay to NOT take something on.

    FreshMD- not letting others' criticisms get to you has been challenging but definitely easier with time -it's about growing up, too, something I STILL feel like I'm doing.

    Kyla- exactly, sister.

    Niquekee- CONGRATS!!! That's awesome. You'll be fabulous. And, thanks. =)

    Kelly- Hey, thanks! Have been thinking about that for awhile.

  9. Thanks for helping me understand your teroir and reflect upon mine.This is wonderfully well thought out! Thank you for sharing!

  10. I love the concept of terroir. So true that your daily contentment and happiness truly depends on it.

  11. Thanks for your perspective. I understand your need to connect to work on vacation time but dont you think this takes away from family time?- Maybe it lasted short enough that it didnt but knowing myself, I would be mulling over the issues discussed the whole day anyway (my on-off switch is broken i know). I have a middle aged, unmarried boss with no kids who wouldnt even answer office related emails on his days off even in emergency situations not concerning him; talk less of taking calls......I am trying to take after him. I try not to call in or participate in work related activities while on vacation (no matter how much I miss it) nor involve colleagues that are away in such activities. Like you, I can't imagine not working for a considerable length of time (i have maternity leave coming up and that is going to be tough). Thanks for changing policy in your environment....that is a lasting impression that nobody will remember you for but evryone wil appreciate!


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